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Doctors' Answers to "Frequently Asked Questions" - Prednisone

These comments are made for the purpose of discussion and should NOT be used as
recommendations for or against therapies or other treatments. An individual patient is
always advised to consult their own physician.

[posted 01/26/2000]
Question: My son and his wife choose not to vaccinate their children against and diseases. My question is since I have active Sarcoidosis and am taking Predisone, and if they come down with either measles or chicken pox and I am exposed, will it endanger my life? Thanks Diana

Answer: Probably not, there is some suppression of your immune system. But, in clinical reality, one doesn't see the number of infections that are theorectically possible. Assuming you have had these diseases, you should be ok. I would avoid intimate contact, otherwise act normally.

[posted 11/30/1999]
Question: I have been diagnosed with Rheumatoid Arthritis in both my ankles and my left wrist. My doctor prescribed Prednisone - at first I was taking 15 mg/day and I am now taking 10 mg/day along with 2.5 mg/wk. of Methatrexate. I take 2 Meth. tablets/week. The treatment is definitely working. I will eventually be taking only 5 mg. of the Prednisone. However, I've about some of the side and am curious about them since in 6/98 I suffered a mild MI. I had angioplasty for one clogged artery. Since I started taking the Prednison I seem to have difficulty catching my breath. I have just begun working out again and don't experience any shortness of breath when I'm exercising. Usually at rest. I'm also strength training and wondering will that help prevent the possiblity of Osteo. I'm thoroughly enjoying being able to walk pain-free again but am certainly concerned about all the side effects of my Rx treatment. My doctor says I'll probably have to take the Methatrexate for an indefinite period of time. Should I be worried with my heart condition and all? I need to lose about 50 lbs. and am trying to eat healthy and exercising on a regular basis. Both my primary care doctor and Rheumatologist have said it's okay as long as I don't overdo things. Given the fact that I had a clogged artery I am concerned about the effects of Prednisone on the arteries. I would appreciate any feedback you could give me. Also, I have been experiencing slight pain in my lower back the last few days. Could this be from the Rx's.?

Answer: Prednisone will accelerate the restenosis of your artery. But, you have few options. Keep your cholesterol as low as possible while you are on the prednisone. Also, get a base line bone density and if low at all start some preventive treatment(Fosamax, Miacalcin etc.).

[posted 10/29/1999]
Question: My doctor has recommended a combination of prednisone, baby aspirin, heparin, and progesterone in an effort to prevent miscarriage. I am very concerned about the effects of these drugs on the fetus, especially prednisone. Can you help me understand more about what the risks are? Thank you!

Answer: I need to know why you are at risk. But, prednisone in small doses would not be a big risk. Your pediatrician needs to know of these to observe your child for adrenal problems long term, this would depend a lot on the dosage of Prednisone.

[posted 10/16/1999]
Question: My wife and I are currently trying to conceive. I am currently taking Asacol and Prednisone for Ulceritive Colitis. I was taking Sulfasalizine but my doctor switched me to Asacol 10/98. I have been on Prednisone since 7/99 due to the fact that the Colitis has been acting up. Do either of these drugs have any affect on my sperm or the developing fetus when we do get pregnant?

Answer: Not usually.

[posted 08/13/1999]
Question: I have akready read your FAQs but have been unable to find the answer I am seeking. I started on 100mg of Prednisone,
tapering to 40 mg in 2 weeks. Thereafter, I was on 40 mg for
5 weeks, down to 30 mg for 1 week, 25mg for 1 week, 20 mg for 3 months, back up to 100 for 8 days, tapering down to
zero in 2 weeks. Is this considered long-term usage? After
stopping the drug, I went into a severe depression for which I have now been on Prozac for 6 weeks, which has helped considerably. Also, the results of a recent bone
density scan revealed the beginning of osteoporosis in my left hip. Would this have anything to do with the Prednisone or is it more likely related to anuual Prednisone injections in that hip over the last 5 years for
bursitis? In case you are wondering, the Prednisone was being used to treat pain associated with an inflammatory condition of my eye which remained undiagnosed for 9 months.
I was finally diagnosed with a psuedotumor behind my right eye and received 10 radiation treatments this past March.
Unfortunately, I do have permanent damage to my vision, due
to compression of the optic nerve. Thank you for your help.

Answer: Long term usage of prednisone causing adrenal insufficiency symptoms on withdrawal usually takes 3-6 months. Three for older patients and six for younger. As to the osteoporosis, this is either age induced or secondary to your previous injections, hard to know.

Prednisone Withdrawal [posted
1/14/99] Question: I am aware of most of the side effects from prednisone, having been on it
for nearly 10 years. I have finally reached a maintenance dose of 5 mg and trying
desperately to wean myself off it. Could you please discuss the withdrawal symptoms? My
legs ache so badly that I can hardly lift them. Could this be one of the symptoms?
Appreciate any advice or comments.

Answer:Sure, as to the withdrawal, you need to ensure that your
adrenal glands have become active again or you will experience symptoms of Adrenal
Insufficiency (Addison's Disease). Have your doctor perform an ACTH stimulation to see if
they're working. If not you need a regimen to get them back (usually every other day or
every third day omission).

Prednisone [posted 1/6/99] Question: Is Prednisone drying/binding? Can it cause difficulty concerning bowel
movements? Can it cause mega-bowel? Does it dry skin and hair? I am taking just 2 mg per
day for the relief of arthritis pain. What is the drug coming out in February for this
disease?

Answer: Not usually constipating, but occasionally affects the
skin and hair. The drug coming out in February is a whole new class of anti-inflammatory,
which will decrease inflammation without the GI risk.

Prednisone taken with
Anti-Depressants [posted 1/5/99] Question: I'm taking prednisone for polymyositis 20 mg plus Anti-depressants
depakote and effexor. Are anti-depressants effective with taking Prednisone? is this a
blocker of any kind.

Answer: They will still work, but potentially modified by the
psychological effects that prednisone has on some patients.

Prednisone [posted 1/5/99] Question: I'm taking prednisone for polymyositis 20 mg every other day. I started
at 80mg. I am in a depression as well. I am taking anti-depressants 500 mg/day of Depakote
and 150 mg of Effexor/day. Does the dose prednisone prevent the anti-depressants or
interfere with the effectiveness for the depression.

Answer: No, but steroids do have mental status changes in about
10-20% of patients unto themselves.

Anti-depressants taken with
Prednisone [posted 1/4/99] Question: I am a 65 year old female diagnosed with polymositis and am taking
prednisone. I also have depression and have taken effexor depakote. How affective are the
anti-depressants taken with prednisone? My depression is still with me. Is the prednisone
blocking the anti-depressants?

Answer: Steroids clearly cause mental status changes in some
patients. It is variable and seems dosage dependent. Whether it helps/alters the
depression would vary a lot from patient to patient. So, maybe yes, maybe no.

Prednisone Dosage for Sarcoidosis [posted
11/24/98] Question: I have been diagnosed with sarcoidosis, level 1. My ACE level is 264,
calcium a little high, and lungs are involved. The treatment plan: Prednisone 40 mg
daily for one month; 40 mg every other day for two months; 30 mg every other day for two
months; 20 every other day for two months; then 10 etc until I have been on it for 12
months. My question is: would this be considered long term and a considerable amount
of steroid intake and what are the changes or percentage of possibility that I will
experience long term effect i.e. accelerated aging, hardening of the arteries, glucoma,
etc.? I realize that this question is hard to answer. I am just looking for additional
input from people who are knowledgeable in the field, other than my doctors here in
Michigan. Thank you so much.

Answer: A little longer than average;but, they are describing
the potential course. In fact, it will depend a lot on how your individual disease
responds. You can block some of the osteoporosis with drugs like Fosamax and Miacalcin,
the other side effects will be present and will be dose and duration dependent. However,
there is no other treatment and this can be a fatal disease. If you need a second opinion,
the University of Michigan (Ann Arbor) has a world class dept of Rheumatology.

Can Prednisone Be Causing Mood Swings
[posted 11/4/98] Question: Are personality changes (such as mood swings, testiness, short term
memory loss, rapid topic switching, etc..) a known symptom of prednisone use? Jeanine was
on 100mg of prednisone per day and has been tapering down by 20mg increments. She now is
down to 5 mg per day and is about to stop taking the medication. Since she was on 100 mg,
there have been noticeable personality changes, usually evident in mood swings, and
generally being unpleasant, combative and obsessive. If these symptoms could be related to
the prednisone use, can we expect these symptoms to disappear when she stops the
medication and processes what is in her system?

Answer: Probably the prednisone and it should revert to normal as the dosage is
decreased.

Prednisone Withdrawal Concerns[posted
10/30/98] Question: My doctor prescribed Prednisone to reduce symptoms of colitis. I am
reducing dose while making sure symptoms are under control. My question is on scheduling
the dose during the day. I am now at 35 mg/day. I doubt that a lower dose will be
effective. Is it better to take it in 2 equal doses, or more doses? Will fewer doses help
keep the adrenal glands working? I have been on Prednisone now for 4 months, How long
before the damage to bones, becomes significant? Will oral over the counter calcium with
vitamin D reduce damage to bones ?

Answer: Morning is the best time to avoid adrenal suppression, evening the
worst. That is the reason that we don't split doses, although as an antiinflammatory, it
probably works somewhat better in split doses. While taking these doses of prednisone,
most physicians recommend calcium, vitamin d and either fosamax or miacalcin to avoid bone
loss, discuss this with your physician.

Prednisone Withdrawal Concerns[posted
10/30/98] Question: What are the symptoms usually associated with Prednisone withdrawal? I
was treated with 15mg/day for polymyalgia rheumatica starting 11/97. I tapered very
gradually and have been off of it completely since 7/98. I am 61 years old. My muscles
ache like I have the flu, they feel weak, and my ankles are slightly swollen. I have pain
in my feet, knees, and hips when I first stand up, but I can walk a mile OK. Could these
symptoms be associated with stopping Prednisone? If so, how long can I expect them to
continue? I had blurred vision for about a month afterwards, but that has cleared up. My
doctor wanted me to go back on Prednisone, but I'd rather not. I'd appreciate hearing your
opinion. Thank you.

Answer: Hard to know sometimes if you have steroid deficiency or a return of the
PMR. Has your sedimentation rate been rechecked? If normal, then could be adrenal
insufficiency. This can be checked by a cortrysn stimulation test to test adrenal
response. However, if your sed rate is up sounds like the PMR is still active.

Does Prednisone Cause Severe
Headaches [posted 10/28/98] Question:My 11 year old daughter is currently taking 35 mg prednisone for an
inflammatory bowel disease (possible Crohn's) She has been taking prednisone for close to
three months now, began at 60 mg and is tapering down over the next 9 weeks. She has
started having headaches and says the pain is around her eyes and back of head. Could the
prednisone be causing these severe headaches?

Answer: Possibly, but unlikely. Check with your doctor.

Prednisone & MS [posted
10/21/98] Question:I have been Dx'ed with Possible/Probable MS. When I have a worsening of my
condition, My Dr. usually prescribes short term, high dose prednisone (60mg x 5 days, 40mg
x 5days and 20mg x 5 days) My question is, is there any other drug that works like
prednisone without the side effects? When I take prednisone, it works wonderful and very
little side effects (increased appetite and urinary frequency), but I am concerned by what
I have read about other possibilities and the long term effects. I do believe a repair of
myelin is right around the corner and don't want to be messing up other parts of my body
while waiting.

Answer: Unfortunately not at this time. But, there are other alternatives to MS,
interferon etc. Are you on these?

Prednisone Effects on Sex Drive [posted
10/13/98] Question: Can short-term or long-term use of varying doses of Prednisone for the
treatment of severe asthma in a 32 year old male cause a decrease or even disappearance of
the sex drive?

Answer: Not usually, but, there are many personality changes that have been
described

Prednisone Information [posted
10/9/98] Question: I would like any information about prednisone that you can give me; I am
interested in the long term side effects,dosages etc. I am currently on chemotherapy for
breast cancer and receiving CMF. I also have ITP which has complicated matters. Can you
help me find out anything?

Answer: Steroids are great anti-inflammatories, but, tend to age the body more
rapidly. That is cause cataracts, hardening of the arteries, diabetes, etc. This is dose
and duration related. But, your dosing etc. will be dictated by your disease. There should
be an attempt to minimize the osteoporotic causing effects of steroids by using drugs such
as Fosamax, Miacalcin, etc. You need a long discussion with your doctor

Prednisone & Weight Gain [posted
10/9/98] Question: I read prednisone transfer fat to the abdomen area, will there always be
extra fatty tissue around abdomen of person who used prednisone or with good diet and
exercise can person return abdomen to normal

Answer: In the early stages, it will go back to normal. After extended use, it
tends not to.

Prednisone Effects [posted
7/31/98] Question: I had been on prednisone 5 mg daily and higher doses when needed for
acute asthma, for almost 20 years. I finally was able to be weaned off entirely last
spring. Since then I've used other medications successfully. Now I have been told that the
tendentious I have in both my hands, mainly the thumbs and ring fingers is due to the
steroid prednisone. The tendons have loosened. Any information on this problem would be
greatly appreciated. I was also on this medication during the first 5 months of my
pregnancy. Is there anything I should be aware of or look out for in this child's health?

Answer: Steroids main side effect is to increase many parameters of aging. This
includes arthritis, degenerative changes of joints, etc. These are all well documented. As
to the specifics of your problem, it would be hard to say without examining the problem.
There would be little problem with the pregnancy at the dosage you were taking.

Prednisone [posted 7/30/98] Question: I am curious as to how prednisone causes a decrease in inflammation.
Biochemically, how does this drug work?

Answer: It appears that they inhibit specific functions of white blood cells.
This limits the production of factors necessary to initiate and continue the inflammatory
response. This includes inhibition or decreased production of histamine, leukotriene,
cytokines, arachidonic acid byproducts, and different acute phase reactants. This occurs
in basophils, fibroblasts, lymphocytes, macrophages and endothelial cells.

Prednisone and Cataracts [posted
7/27/98] Question: I was looking for information on prednisone. I need to take this
medication for arthritis pain. I also take daypro 1200 mg each day. I now have the first
stages of cataracts in both eyes. I am taking only 6 mg of prednisone I have been up to 35
mg when I was in more pain. Is there any information on how fast eye problems progress?

Answer: Everyone is different, but it will speed up cataracts - depending on
your current age and your history of family cataracts. It is dose and time dependent. This
means use as little as possible for as short as possible. However, if it is effective you
will need it. I assume you are receiving treatment for steroid induced osteoporosis while
you are taking steroids. This is necessary to decrease the risk of the osteoporosis seen
with steroid use.

Prednisone [posted 7/24/98] Question: How safe is it?

Answer: This drug should be avoided if there is any other treatment option
available. However, for many medical conditions there are no alternatives. Side effects
depend on dosage and length of time taken and generally are equivalent to early aging:
cataracts, osteoporosis, diabetes mellitus, muscle weakness, etc.

Prednisone [posted 7/21/98] Question: My wife has recently been prescribed the drug Prednisone for Ulcerative
Colitis. I know it's a steroid, but what does it do and what are the side effects? Is it
hard to get off of it afterwards?

Answer: Prednisone is a steroid and this steroid (and most of them) are strong
anti-inflammatories. Since her disease is a disease of inflammation/immune system, this
medication will reduce the inflammation, thickening and pain of the disease. Hopefully,
inducing a remission which will last for a while-depending on the severity of her UC.
However, there is a price- steroids speed up the aging process. That is, cause cataracts,
hardening of the arteries, thinning of the bones, muscle weakness, etc. Unfortunately,
there is no drug alternative that reduces the inflammation without these side effects. We
try to use the least steroid to achieve the needed result. She should be taking Fosamax or
something equivalent while she is on the steroid to reduce the bone loss. They are not
addicting, but will suppress her own ability to produce steroids by her adrenal glands.
This necessitates a taper if they have been used a long time (over 3 months for young
people, 1-2 months for those over 65).

Abrupt Stop of PrednisoneQuestion: I have been prescribed prednisone (60 mg a day for 12 days and then to
stop with out tapering), but every thing I read says abrupt stopping of prednisone can
have serious side effects, including death. I would like to know if the 12 days at 60 mg
is short term enough so as not to be concerned about all the emphatic warnings about
abrupt stopping the prednisone.

Answer: Anything less than 3 months or so can tolerate abrupt stoppage without
problems. Over three months would depend on your age and the steroid dosage, but most
would have some sort of taper at that point. I wouldnt be concerned with short
bursts and abrupt stoppage.

Reaction to prednisoneQuestion: I am a 37 year old female recently diagnosed with bursitis in my left
hip. My doctor put me on prednisone (4 pills for 4 days, 3 pills, 3 days, etc.). I felt
very odd the first few days (hard to concentrate) but on the fifth day of taking the
medicine I couldn't go to sleep and I felt like I was going crazy. When I did get to sleep
I had nightmares and woke up soaking wet. My head and face was swelling and my shoulders
and chest were tender to the touch. I quit taking the medicine the next day and the
symptoms are still lingering 7 days later but getting better. My tongue feels tingly and
dry (odd). My head felt like a rubber band was wrapped around it for days. I also felt
like I had the flu or like morning sickness felt in pregnancy. Snapping green beans was a
major chore for my brain to do (which pan to put the strings in?) Is this a normal
reaction. Is it allergic or side effects of the prednisone?

Answer: These are more severe and last longer than usual. However, probably are
due to the steroids. If they don't go in a week, see your physician. After that amount of
time they are not due to the prednisone.

Prednisone and Motrin in combinationQuestion: I am trying to find if there is evidence of negative results from the
interaction of Prednisone and high dosages of Motrin. A woman of approximately 70
experienced serious stomach problems leading to perforation of her small intestine that
required major surgery. She was told that the ulceration was caused by the drug
combination. Any actual or anecdotal information on this problem?

Answer: Prednisone and any of the steroids can cause ulcers in the stomach--
referred to as Cushing Ulcers. Any non-steroidal anti-inflammatory can cause ulcers. The
two together has an increased risk. I can't quote the odds. The PDR and any pharmacology
text makes clear reference to this problem and physicians are taught this from the outset
of their training.

PrednisoneQuestion: I am interested particularly in the psychological side effects of
Prednisone. I have been given to understand it can cause anger, delusions, paranoia and
psychotic episodes. Can you elaborate on these please?

Answer: Steroids can produce a wide variety of psychological changes. Clinically
you see this in about 5% of patients. It seems to be dose related and high IV doses cause
more problem than small oral doses. Many patients will experience euphoria and some
difficulty sleeping. Anger, delusions, and paranoia are less common. An occasional patient
will become psychotic on these drugs. I have seen one psychotic patient on steroids in my
20 years. He was on high IV doses and was also being treated for CNS lupus-- hard to know
which caused the problem. It is an occasional problem. Minor mood problems are common.

PrednisoneQuestion: I am a 24 year old mother of a 5 month old son, and I have Multiple
Sclerosis. I have not had any relapse since my sons birth except a tremendous headache
accompanied with light nausea and dizziness. My Neurologist started me on Prednisone to
take 3 tablets of 25mg for 4 days, then 2 tablets for 3 days and one tablet for 2 days. Do
you think this will have any kind of long term effect on me? I would love to have another
child but was not sure if this would effect me.

Answer: A short course of prednisone will have no permanent or lasting side
effects. It would not impair your ability to either get pregnant or remain pregnant. Women
who need prednisone during pregnancy usually have no problems with their offspring--
except the pediatrician needs to observe them to ensure their adrenal glands develop
appropriately.

PrednisoneQuestion: Is there certain foods that could cause some reaction to this medication.
This information is for my sister who has membrinessneprities.

Answer: I am not aware of food interactions with steroids.

PrednisoneQuestion: I recently went to my doctor for an inflammation in my shoulder and neck.
He took x-rays of my neck and diagnosed some some evidence of arthritis in my neck and
slight touching of tow vertebras and prescribed the drug prednisone. I checked this
drugs side effects and asked my doctor for another drug. My doctor said this was the
only one. I can't believe that. Do you have any suggestions for drugs for inflammation?

Answer: From your description, it sounds like you presented to your physician
with shoulder and neck pain or irritation. Although it is not clear what type of
"x-rays" you are referring to (standard radiographs, cat scan, MRI, etc.), it
appears that you have evidence on these tests of arthritis in your neck, or cervical,
vertebrae. This can result in pinching of, or pushing on, one or several of the nerves
that supply your neck, back, and arms. There are many medications that can be used to
treat the symptoms of this condition, as well as the inflammation, or irritation of the
nerves involved. A class of medications known as NSAID's, or non-steroidal
anti-inflammatory medications are quite effective in reducing inflammation as well as the
pain that accompanies it. An important point, however, is whether the bony changes seen on
x-ray involve large nerves or the spinal cord itself. In these cases it is often important
for prednisone, a corticosteroid, to be used to avoid significant inflammation and damage
to these large nerve strictures. From the information you have provided it is difficult to
say, but perhaps another discussion with your physician will provide you with the
information necessary to determine why the prednisone is needed in your case. It is true
that corticosteroids do have many side effects, but when properly used under the
supervision of a physician they can be taken safely.

Adverse effectsQuestion: Approximately 2 1/2 months ago I was given a prescription of prednisone,
60mg 5 days, 40mg 5 days, 20 mg 5 days. On the 11th day, my first day 0f 20 mg, I
discontinued the drug. Since then I've experienced all side effects. The third day of
withdrawal my symptoms were nausea, headaches, and panic. After a couple of weeks I was
fine until I drank alcohol. My symptoms returned. After another two weeks I went back on 5
mg and was directed to taper off in 4 weeks. Unfortunately after a week, I went to the gym
and worked out very hard and once again it all returned. I refuse to believe I have a
panic disorder. Presently, I feel better but not myself. According to other research I've
done many others have experienced something similar. In the past I've never experienced
nervousness. Is there an easy answer? I've heard so many different solutions. What is the
specific physical problem, and why does it still persist? Where can I find more
information?

Answer: This is not due to the steroids that you were taking unless you had
previously taken larger doses for longer periods of time. In the time frame that you have
taken prednisone, withdrawal would have minor problems unless you had another problem. Why
were you taking the steroids?

CorticosteroidsQuestion: Could you please explain if there is a difference between prednisone,
decadron, and dexamethasone?

Answer: Dexamethasone is the generic form of decadron. Prednisone differs mainly
in terms of potency. Prednisone is about 4-5 times as potent milligram for milligram as
cortisol. Dexamethasone is about 20-25 times as powerful mg for mg. Prednisone also has
slight sodium retaining potential that dexamethasone does not have. Prednisone lasts
longer than cortisol but shorter than dexamethasone.

Prednisone causing OsteoporosisQuestion: I would like to have some information by one of the doctors who answers
the questions.

Answer: Steroid induced osteoporosis is common and will occur with any one who
takes steroids. Like most steroid side effects it depends on the dosage and the length of
time. Small doses for short periods of time have negligible side effects. Larger doses or
longer periods of time will thin the bones. The treatment is Vitamin D and Calcium
replacement while one is taking steroids. There currently is research ongoing with Fosamax
and nasal calcitonin, but it is not yet available. Some physicians are prescribing Fosamax
to patients on long term system steroids assuming it will be of benefit.

PrednisoneQuestion: I am currently using prednisone for sinusitis due to allergies. I have
been taking desensitization shots for three years, but this hasn't helped the sinusitis. I
take 10 mg of prednisone (usually 5 tablets over four days) as needed (which is every two
weeks or so). I worry about this kind of sustained use. What could be the side effects?

Answer: I would really not recommend long term use of steroids for sinusitis. If
steroids work systematically, they should work as topical spray. Use of steroids for a
short period each year-- say two to three weeks might be warranted, but long term use is
not.

PrednisoneQuestion: What are the potential side effects of an overdose of prednisone in a 10
year old child weighing 80 pounds?

Answer: Overdose can be for either one day or several days. A high dose for one
day should have minimal effects. Occasional people get confused and there is an occasional
person who actually can become psychotic, although this is rare. Huge doses of steroids
are usually tolerated without any special problem other than difficulty sleeping. Long
term use of high doses is another matter.

PrednisoneQuestion: I have had a reaction to Prednisone, which include muscle weakness,
swelling in my face and shoulders, rash, headaches, loss of sleep and swelling of my
tongue. Can you give me any information on how long it will take for these conditions to
clear? Can I do anything to speed the process?

Answer: Why were you taking Prednisone in the first place? Muscle weakness can
occur with prednisone, as can swelling of the face, and also sleeping difficult. However,
swelling of the tongue and headaches would be unusual. The sleeping difficulty will clear
fairly rapidly after cessation of prednisone. The swelling of the face and muscle weakness
will last for several weeks to months (depending on dosage and the length of time you were
taking prednisone). The longer that you take Prednisone and the larger the dosage, the
more side effects and the more time it takes to clear. Some side effects like cataracts,
hardening of the arteries, and osteoporosis do not seem to correct.

Prednisone timetableQuestion: I recently began taking Prednisone for ocular myasthenia, and started at
10 mg a day for a week and added 5 mg a week until I reached 30 mg a day. Once I reached
30 mg a day I finally began to see some results. I'm getting differing opinions about
whether it's better to take the full dose in the morning, or better to spread it out
throughout the day. One source says multiple doses throughout the day are more effective,
but more toxic, and another says a single dosage in the morning is more beneficial and
less harmful. What is your opinion?

Answer: Multiple doses of steroids are more effective, but also will suppress
your adrenal gland more effectively. We try to space out steroid dosing to avoid adrenal
suppression (so that your own adrenal will "kick in" after you stop the
steroids). Other side effects and toxicities of multiple dosing have not been well
studied.

PrednisoneQuestion: What are the side-effects of prednisone? I take it on an irregular basis
for the symptoms of a condition known as Behcet's syndrome. My usual pattern is 20 mg the
first day then 10 mg the next day, continuing for approximately 7 days, then 5 mg for
about 3 days. My symptoms always completely clear up the first day, though. This usually
keeps me for about 1-3 weeks before I begin the process again. Are there any substitutes
for the drug with less side-effects? What about a drug called methylprednisone?

Answer: The major effects of steroids is to accelerate the aging process. So,
hardening of the arteries accelerated, diabetes develops, cataracts, osteoporosis,
degeneration of the cartilage surfaces of the body. We try to minimize the length and dose
due to this problem. Unfortunately, there is no other drug which will accomplish their
anti-inflammatory effect. Methylprednisone is a similar drug in terms of effects and side
effects.

Long-term EffectsQuestion: I have been taking 5 mg prednisone per day for about a year. What are the
long term affects of this dosage? I take it for a sex hormone deficiency.

Answer: You have a different problem than many people. An inherited enzyme
deficiency that wont allow proper steroid development. This is treated with
prednisone (or equivalent). Side effects at this dose should be fairly minimal, especially
with your specialized problem.

PrednisoneQuestion: What are the side effects of Prednisone?

Answer: Prednisone mainly acts to speed up the aging process of the body. Hence,
hardening of the arteries will accelerate, cholesterol is higher, osteoporosis is faster
and more severe, the blood sugar is higher, cataracts form, muscles atrophy and lose
strength, fat forms around the abdomen, the legs thin, and the skin thins. In general,
think of any aging effect that you see on any organ and prednisone will accelerate this
effect.

PrednisoneQuestion: Is 5 mg of Prednisone given to aging dogs equivalent to the 5 mg tablets
given to humans?

Answer: Yes.

PrednisoneQuestion:Would you please provide me with some information on this drug, and its
side effects?

Answer:Prednisone is a glucocorticoid(steroid). It is used to treat many
different conditions which require either a strong anti-inflammatory or to decrease the
immune system. Once absorbed prednisone is metabolized in the liver to the active drug
prednisolone. There are some people who have difficulty with this metabolic step and
should be given prednisolone. Prednisone should he given in the smallest dose for the
shortest time necessary. This is because prednisone accelerates the aging process of the
body. Consequently, it increases the rate of hardening of the arteries, increases
osteoporosis, can cause diabetes mellitus, increases the cholesterol, causes cataracts.
For all the bad things that prednisone(and similar drugs) cause it is often the only drug
available to treat certain conditions. Question: Can prednisone effect a man's ability to conceive children?

Answer: Prednisone has many deleterious side effects, but rarely affects sperm
production or viability.

PrednisoneQuestion: Does Prednisone have any indications that it will promote the
spread of the disease.

Answer: Prednisone is a glucocorticoid which is generally used as an
anti-inflammatory. It has numerous effects on the body in addition to its
anti-inflammatory effects. In general, these act to accelerate the aging process. In
addition, there is a suppressive effect on the immune system. Prednisone is often used in
organ transplant patients for this very effect. Consequently, one could argue that
steroids will increase the rate of cancers by decreasing the ability of one's body to find
and kill cancers. While this is probably true, certain patients cannot exist without the
effects of prednisone. Prednisone is rarely used without consideration for its potential
side effects. It should never be used for long periods without good cause.

Prednisone and osteoporosisQuestion: Having taken 5 mg of prednisone for the last ten years after
having had my pituitary removed, I have been told now that I have compressed fractures of
the spine due to softening of the bone as a side effect of the prednisone. I am 74 years
of age and find this condition very incapacitating for the low back pain. I suppose this
condition amounts to osteoporosis...or a form of it. Any suggestions?

Answer: Prednisone as any steroid certainly increases the rate of bone
loss leading to osteoporosis. In the last few years, we have started adding calcium and
vitamin D while patients are on prednisone to avoid this problem. It may be that drugs
like Fosamax used during treatment with Prednisone will also help. Research is in
progress. I would ensure that your physician has checked other causes for compression
fractures-namely, hyperparathyroidism, Vitamin D deficiency, hypo or hyperthyroidism-all
are common and you will continue to have bone fractures if these are not corrected.

Personality ChangesQuestion: Psychological effects such as personality changes &
depression can occur with short term use of prednisone. My father was treated for a severe
bronchial infection with prednisone for 1 month at the maximum dosage allowable. Since
then, he has become a completely different person depressed, hopeless, and very
distraught, to the point that he has indicated that he is leaving our family after 30
years. He cannot provide any reason as to why he feels this way. I'm curious to find out
if this personality change is due to his prednisone treatment and if so, how can it be
reversed?

Answer:The personality effects sometimes seen with steroids are
usually dose related and will disappear after 4-5 days(maximum) after stopping the drug.
In general, I see few effects on personality and they are less common after the dosage is
decreased below 20 mg. They are not the source of the problem if he is off the drugs in
excess of 3-4 days.

Children w/ITPQuestion: Is Prednisone usually prescribed for a child who has been
diagnosed with ITP? It is not determined yet if his disease is Cronic ITP. He is about 2
yrs old.